CT在评估髌股关节排列中的应用

Evaluation of CT in the investigation of patellofemoral malalignment ZHANG Quan, HUANG Huang

目的介绍和分析利用ＣＴ评估髌股关节排列的方法和价值。方法在屈膝３０°时用ＣＴ检测３２例５０侧膝髌股关节疼痛者（轴位Ｘ线片上髌股排列基本正常）和１５例２０侧膝无症状者的髌股关节，测量其髁间沟角、和谐角及外侧髌股角，观察病变在ＣＴ上的表现，分析髌股关节疼痛患者的髌股排列状况。结果髌股关节疼痛患者较无症状者具有较明显的髌股排列紊乱，单纯髌骨外置者１１侧膝，单纯髌骨倾斜者８侧膝，髌骨外置合并髌骨倾斜者１０侧膝。结论利用ＣＴ评估髌股关节排列较普通Ｘ线片有显著的优越性。

Objective To evaluate CT in investigating patellofemoral malalignment. Methods CT was used to evaluate 32 patients (50 knees) with persistent patellofemoral pain and 15 asymptomatic volunteers (20 knees). Multiple midpatellar images were obtained at 30 flexion. Results Compared to controls, the patients had marked malalignment including three distinct patterns. 11 knees had lateralized patellae based on high congruence angles (CA). 8 knees had tilted patellae with lower lateral patellofemoral angles (LPFA). 10 knees had both high CA and lower LPFA indicating both lateralized and tilted patella. Conclusions CT may be the optimal imaging method of evaluating the patellofemoral joint. An awareness of different patterns of malalignment is a significant advantage of CT when planning selective surgical realignment for these patients.